There are a number of feeding strategies that could potentially increase the risk of childhood obesity, however there is limited evidence supporting any consistent associations.

• Grade I means there is Good/Strong evidence supporting the statement;
• Grade II is Fair;
• Grade III is Limited/Weak;
• Grade IV is Expert Opinion Only;
• Grade V is Not Assignable.
• High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
• Moderate (B) means we are moderately confident in the effect estimate;
• Low (C) means our confidence in the effect estimate is limited;
• Very Low (D) means we have very little confidence in the effect estimate.
• Ungraded means a grade is not assignable.

• Detail

Parental dietary disinhibition and restraint may be related to a higher risk of overweight in children. Parents are likely to exert control over their children’s behavior in areas that are important and potentially problematic for themselves; however these studies have only been conducted among predominantly white, middle-class populations and therefore these results may not be applicable to other populations.

• Grade I means there is Good/Strong evidence supporting the statement;
• Grade II is Fair;
• Grade III is Limited/Weak;
• Grade IV is Expert Opinion Only;
• Grade V is Not Assignable.
• High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
• Moderate (B) means we are moderately confident in the effect estimate;
• Low (C) means our confidence in the effect estimate is limited;
• Very Low (D) means we have very little confidence in the effect estimate.
• Ungraded means a grade is not assignable.

• Detail
• Quality Rating Summary
  For a summary of the Quality Rating results, click here.
• Worksheets
  • Cutting TM, Fisher JO, Grimm-Thomas K, Birch LL. Like mother, like daughter: Familial patterns of overweight are mediated by mothers’ dietary disinhibition. Am J Clin Nutr 1999; 69: 608-613.
  • Davison KK, Birch LL. Obesigenic families: Parents’ physical activity and dietary intake patterns predict girls’ risk of overweight. Int'l J Obes. 2002; 26: 1,186-1,193.
  • Fisher JO, Birch LL. Restricting access to palatable foods affects children’s behavioral response, food selection and intake. Am J Clin Nutr 1999; 69: 1,264-1,272.
  • Hood MY, Moore LL, Sundarajan-Ramamurti A, Singer M, Cupples LA, Ellison RC. Parental eating attitudes and the development of obesity in children. The Framingham Children’s Study. Int J Obes 2000; 24: 1,319-1,325.
  • Johnson SL, Birch LL. Parents’ and children’s adiposity and eating style. Pediatrics 1994; 94: 653-661.
• Related Topics

Positive aspects of family functioning such as family cohesion, expressiveness, democratic style, parental support and cognitive stimulation at home may be protective against childhood overweight, while other negative aspects of family functioning such as lack of parental support or over-possessiveness may be associated with overweight in children. At present, however, it is challenging to compare studies because of different constructs used to assess family functioning.

• Grade I means there is Good/Strong evidence supporting the statement;
• Grade II is Fair;
• Grade III is Limited/Weak;
• Grade IV is Expert Opinion Only;
• Grade V is Not Assignable.
• High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
• Moderate (B) means we are moderately confident in the effect estimate;
• Low (C) means our confidence in the effect estimate is limited;
• Very Low (D) means we have very little confidence in the effect estimate.
• Ungraded means a grade is not assignable.

• Detail
• Quality Rating Summary
  For a summary of the Quality Rating results, click here.
• Worksheets
  • Lissau I, Sorensen TIA. Parental neglect during childhood and increased risk of obesity in young adulthood. Lancet 1994; 343: 324-328.
  • Lissau I, Breum L, Sorensen TIA. Maternal attitude to sweet eating habits and risk of overweight in offspring: a ten-year prospective population study. Int J Obes 1993; 17: 125-129.
  • Mendelson BK, White DR, Schliecker E. Adolescents’ weight, sex and family functioning. Int J Eat Disord 1995; 17: 73-79.
  • Strauss RS, Knight J. Influence of the home environment on the development of obesity in children.
    Pediatrics. 1999 Jun;103(6):e85.  
  • Trombini E, Baldaro B, Bertaccini R, Mattei C, Montebarocci O, Rossi N. Maternal attitudes and attachment styles in mothers of obese children. Percept Mot Skills. 2003 Oct;97(2):613-20.
  • Valtolina GG, Marta E. Family relations and psychosocial risk in families with an obese adolescent. Psychological Reports 1998; 83: 251-260.

Parental concern about child’s weight status may be associated with overweight in children; however a majority of the research has been conducted among non-Hispanic, white girls and may be applicable only to this population.

• Grade I means there is Good/Strong evidence supporting the statement;
• Grade II is Fair;
• Grade III is Limited/Weak;
• Grade IV is Expert Opinion Only;
• Grade V is Not Assignable.
• High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
• Moderate (B) means we are moderately confident in the effect estimate;
• Low (C) means our confidence in the effect estimate is limited;
• Very Low (D) means we have very little confidence in the effect estimate.
• Ungraded means a grade is not assignable.

• Detail
• Quality Rating Summary
  For a summary of the Quality Rating results, click here.
• Worksheets
  • Agras WS, Hammer LD, McNicholas F, Kraemer HC. Risk factors for childhood overweight: a prospective study from birth to 9.5 years. J Pediatr. 2004 Jul;145(1):20-5.
  • Birch LL, Fisher JO, Davison KK. Learning to overeat: maternal use of restrictive feeding practices promotes girls' eating in the absence of hunger. Am J Clin Nutr. 2003 Aug;78(2):215-20.
  • Brewis A. Biocultural aspects of obesity in young Mexican schoolchildren. Am J Hum Biol. 2003 May-Jun;15(3):446-60.
  • Davison KK, Birch LL. Weight status, parent reaction, and self-concept in five-year-old girls. Pediatrics 2001; 107: 46-53.
  • Davison KK, Birch LL. Processes linking weight status and self-concept among girls from ages 5 to 7 years. Developmental Psychology. 2002; 38: 735-748.
  • Kelishadi R, Pour MH, Sarraf-Zadegan N, Sadry GH, Ansari R, Alikhassy H, Bashardoust N. Obesity and associated modifiable environmental factors in Iranian adolescents: Isfahan Healthy Heart Program - Heart Health Promotion from Childhood. Pediatr Int. 2003 Aug;45(4):435-42.
  • Spruijt-Metz D, Lindquist CH, et.al. Relation between mothers’ child-feeding practices and children’s adiposity. Am J Clin Nutr. 2002;75:581-586.

• Grade I means there is Good/Strong evidence supporting the statement;
• Grade II is Fair;
• Grade III is Limited/Weak;
• Grade IV is Expert Opinion Only;
• Grade V is Not Assignable.
• High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
• Moderate (B) means we are moderately confident in the effect estimate;
• Low (C) means our confidence in the effect estimate is limited;
• Very Low (D) means we have very little confidence in the effect estimate.
• Ungraded means a grade is not assignable.

• Detail
• Quality Rating Summary
  For a summary of the Quality Rating results, click here.
• Worksheets
  • Agras WS, Hammer LD, McNicholas F, Kraemer HC. Risk factors for childhood overweight: a prospective study from birth to 9.5 years. J Pediatr. 2004 Jul;145(1):20-5.
  • Baughcum AE, Powers SW, Johnson SB, Chamberlin LA, Deeks CM, Jain A, Whitaker RC. Maternal feeding practices and beliefs and their relationships to overweight in early childhood. J Dev Behav Pediatr 2001; 22: 391-408.
  • Birch LL, Fisher JO, Davison KK. Learning to overeat: maternal use of restrictive feeding practices promotes girls' eating in the absence of hunger. Am J Clin Nutr. 2003 Aug;78(2):215-20.
  • Johnson SL, Birch LL. Parents’ and children’s adiposity and eating style. Pediatrics 1994; 94: 653-661.
  • Koivisto U, Fellenius J, Sjoden. Relations between parental mealtime practices and children’s food intake. Appetite 1994; 22: 245-258.
  • Melgar-Quinonez HR, Kaiser LL. Relationship of child-feeding practices to overweight in low-income Mexican-American preschool-aged children. J Am Diet Assoc. 2004 Jul;104(7):1110-9.
  • Robinson TN, Kiernan M, Matheson DM, Haydel KF. Is parental control over children’s eating associated with childhood obesity? Results from a population-based sample of third graders. Ob Res 2001; 9: 306-312.
  • Saelens BE, Ernst MM, Epstein LH. Maternal child feeding practices and obesity: a discordant sibling analysis. Int J Eat Disord 2000; 27:459-463.
  • Sherman JB, Alexander MA, Dean AH, Kim M. Obesity in Mexican-American and Anglo children. Prog Cardiovasc Nurs. 1995 Winter;10(1):27-34.
  • Wardle J, Sanderson WS, Guthrie CA, Rapoport L, Plomin R. Parental feeding style and the intergenerational transmission of obesity risk. Obes Res 2002; 10: 453-462. Twins Early Development Study.

Parental encouragement/ pressure to eat is not associated with increased overweight in children.

• Grade I means there is Good/Strong evidence supporting the statement;
• Grade II is Fair;
• Grade III is Limited/Weak;
• Grade IV is Expert Opinion Only;
• Grade V is Not Assignable.
• High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
• Moderate (B) means we are moderately confident in the effect estimate;
• Low (C) means our confidence in the effect estimate is limited;
• Very Low (D) means we have very little confidence in the effect estimate.
• Ungraded means a grade is not assignable.

• Detail
• Quality Rating Summary
  For a summary of the Quality Rating results, click here.
• Worksheets
  • Birch LL, Fisher JO, Davison KK. Learning to overeat: maternal use of restrictive feeding practices promotes girls' eating in the absence of hunger. Am J Clin Nutr. 2003 Aug;78(2):215-20.
  • Francis LA, Hofer SM, Birch LL. Predictors of maternal and child characteristics. Appetite 2001; 37: 231-243.
  • Koivisto U, Fellenius J, Sjoden. Relations between parental mealtime practices and children’s food intake. Appetite 1994; 22: 245-258.
  • Lee Y, Mitchell DC, Smickiklas-Wright H, Birch LL. Diet quality, nutrient intake, weight status, and feeding environments of girls meeting or exceeding recommendations for total dietary fat of the American Academy of Pediatrics. Pediatrics 2001; 107: e95.
  • Melgar-Quinonez HR, Kaiser LL. Relationship of child-feeding practices to overweight in low-income Mexican-American preschool-aged children. J Am Diet Assoc. 2004 Jul;104(7):1110-9.
  • Robinson TN, Kiernan M, Matheson DM, Haydel KF. Is parental control over children’s eating associated with childhood obesity? Results from a population-based sample of third graders. Ob Res 2001; 9: 306-312.
  • Spruijt-Metz D, Lindquist CH, et.al. Relation between mothers’ child-feeding practices and children’s adiposity. Am J Clin Nutr. 2002;75:581-586.
  • Wardle J, Sanderson WS, Guthrie CA, Rapoport L, Plomin R. Parental feeding style and the intergenerational transmission of obesity risk. Obes Res 2002; 10: 453-462. Twins Early Development Study.

Parental restriction of highly palatable foods may promote children’s desire for such forbidden foods, causing dysregulation of caloric intake and overeating. It appears that this child-feeding practice is associated with overweight in children; however a majority of the research has been conducted among non-Hispanic, white girls and may be applicable only to this population.

• Grade I means there is Good/Strong evidence supporting the statement;
• Grade II is Fair;
• Grade III is Limited/Weak;
• Grade IV is Expert Opinion Only;
• Grade V is Not Assignable.
• High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
• Moderate (B) means we are moderately confident in the effect estimate;
• Low (C) means our confidence in the effect estimate is limited;
• Very Low (D) means we have very little confidence in the effect estimate.
• Ungraded means a grade is not assignable.

• Detail
• Quality Rating Summary
  For a summary of the Quality Rating results, click here.
• Worksheets
  • Birch LL, Fisher JO. Mothers’ child-feeding practices influence daughters’ eating and weight. Am J Clin Nutr. 2000; 71: 1054-1061.
  • Birch LL, Fisher JO, Davison KK. Learning to overeat: maternal use of restrictive feeding practices promotes girls' eating in the absence of hunger. Am J Clin Nutr. 2003 Aug;78(2):215-20.
  • Davison KK, Birch LL. Weight status, parent reaction, and self-concept in five-year-old girls. Pediatrics 2001; 107: 46-53.
  • Fisher JO, Birch LL. Restricting access to foods and children’s eating. Appetite 1999; 32: 405-419.
  • Fisher JO, Birch LL. Restricting access to palatable foods affects children’s behavioral response, food selection and intake. Am J Clin Nutr 1999; 69: 1,264-1,272.
  • Fisher JO, Birch LL. Eating in the absence of hunger and overweight in girls from 5 to 7 y of age. Am J Clin Nutr. 2002 Jul;76(1):226-31.
  • Francis LA, Hofer SM, Birch LL. Predictors of maternal and child characteristics. Appetite 2001; 37: 231-243.
  • Lee Y, Mitchell DC, Smickiklas-Wright H, Birch LL. Diet quality, nutrient intake, weight status, and feeding environments of girls meeting or exceeding recommendations for total dietary fat of the American Academy of Pediatrics. Pediatrics 2001; 107: e95.
  • Melgar-Quinonez HR, Kaiser LL. Relationship of child-feeding practices to overweight in low-income Mexican-American preschool-aged children. J Am Diet Assoc. 2004 Jul;104(7):1110-9.
  • Spruijt-Metz D, Lindquist CH, et.al. Relation between mothers’ child-feeding practices and children’s adiposity. Am J Clin Nutr. 2002;75:581-586.

Based on limited evidence the parental child-feeding practices, Using food as a reward (Instrumental feeding) & Emotional Feeding, which may be considered a specific type of parental control over child’s dietary intake, do not appear to be associated with overweight in children.

• Grade I means there is Good/Strong evidence supporting the statement;
• Grade II is Fair;
• Grade III is Limited/Weak;
• Grade IV is Expert Opinion Only;
• Grade V is Not Assignable.
• High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
• Moderate (B) means we are moderately confident in the effect estimate;
• Low (C) means our confidence in the effect estimate is limited;
• Very Low (D) means we have very little confidence in the effect estimate.
• Ungraded means a grade is not assignable.

• Detail
• Quality Rating Summary
  For a summary of the Quality Rating results, click here.
• Worksheets
  • Wardle J, Sanderson WS, Guthrie CA, Rapoport L, Plomin R. Parental feeding style and the intergenerational transmission of obesity risk. Obes Res 2002; 10: 453-462. Twins Early Development Study.